NPI | 1780111773 |
---|---|
Former Name | BRIDGET STRAUB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111095) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020808) |
Enumeration Date | 2017-05-22 |
Last Update Date | 2021-05-08 |