NPI | 1881862928 |
---|---|
Former Name | RUTH BERNARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C04471) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA00452) |
Enumeration Date | 2008-02-12 |
Last Update Date | 2016-01-11 |