NPI | 1912206830 |
---|---|
Former Name | SYDNEY C. MANBECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01315) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7820) |
363A00000X Physician Assistant (Licence: PA OA002616) | |
Enumeration Date | 2011-03-17 |
Last Update Date | 2021-08-10 |