| NPI | 1346690856 |
|---|---|
| Former Name | COLLEEN CARRERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10605) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 5772) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2023-07-25 |