| NPI | 1366086936 |
|---|---|
| Former Name | COLLEEN ELIZABETH HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7313) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2024-01-22 |