| NPI | 1033119763 |
|---|---|
| Former Name | COLLEEN MICHELE COX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.001342) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-001342) |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10000991A) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2013-10-08 |