| NPI | 1821454513 |
|---|---|
| Former Name | ERICA ANN MUNDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019429) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5483) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2023-12-13 |