| NPI | 1164933255 |
|---|---|
| Former Name | COLLEEN MARIE PLUMMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA059319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059319) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2022-12-20 |