| NPI | 1619379450 |
|---|---|
| Former Name | JOANNA MASTERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017965) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 17965) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2023-06-29 |