| NPI | 1285232793 |
|---|---|
| Former Name | TRINA COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5306) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2022-02-11 |