NPI | 1982826780 |
---|---|
Former Name | CAROL JEAN RATH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 004640) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 004640) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2011-07-12 |