| NPI | 1063417558 |
|---|---|
| Former Name | ELIZABETH A BOLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001498) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002813) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2016-07-14 |