NPI | 1215946561 |
---|---|
Former Name | DONNA IANACONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0000674) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 674) |
Enumeration Date | 2006-08-05 |
Last Update Date | 2015-01-28 |