NPI | 1942471255 |
---|---|
Former Name | ANN-MARIE GADOMSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011646) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 23011646) |
363AM0700X Physician Assistant, Medical (Licence: NC 0010-01804) | |
Enumeration Date | 2008-03-13 |
Last Update Date | 2013-03-06 |