| NPI | 1851868517 |
|---|---|
| Former Name | ELANA MICHELLE GRANOVITZ |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15919) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022901-1) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2024-12-17 |