NPI | 1205024668 |
---|---|
Former Name | KARA C. KOLDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-003130) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003130) |
Enumeration Date | 2007-10-11 |
Last Update Date | 2021-03-04 |