NPI | 1831421114 |
---|---|
Former Name | EMILY ANN BOGUMIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013781) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 13781) |
Enumeration Date | 2010-02-11 |
Last Update Date | 2023-07-07 |