NPI | 1922430776 |
---|---|
Former Name | ERICA HABERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6064) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 6860) |
Enumeration Date | 2013-08-04 |
Last Update Date | 2018-03-17 |