NPI | 1104275163 |
---|---|
Former Name | KALI ANN NOONEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004594) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004594) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2018-11-01 |