NPI | 1144306689 |
---|---|
Former Name | COLLEEN HOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053367) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04371) |
Enumeration Date | 2006-10-27 |
Last Update Date | 2009-02-17 |