NPI | 1124571435 |
---|---|
Former Name | LIANN JACQUELINE BORSKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004696) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004696) |
Enumeration Date | 2016-08-03 |
Last Update Date | 2020-07-24 |