| NPI | 1265799506 |
|---|---|
| Former Name | CARMEN MICHELLE CALDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106520) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9106520) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-05-11 |