| NPI | 1396970612 |
|---|---|
| Former Name | COLEEN DENISE HASSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M11814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN13814) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2014-01-23 |