| NPI | 1760932040 |
|---|---|
| Former Name | EMILY MARISSA REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 020236) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2023-01-11 |