Individual
ELIZABETH MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2591
MA
363AS0400X
Surgical Physician Assistant
Primary
4369
CT
363AS0400X
Surgical Physician Assistant
PA00482
RI
Other
Enumeration date
02/09/2009
Last updated
04/30/2024
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