| 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 |