| NPI | 1861820581 |
|---|---|
| Former Name | MAGDA ANNA SLOBODZIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017117) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2014-05-28 |