| NPI | 1801040613 |
|---|---|
| Former Name | ELYSSA L ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002262) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 23-012973) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2025-04-02 |