| NPI | 1245607449 |
|---|---|
| Former Name | ELIZABETH ANN COULON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2023-08-16 |