NPI | 1407579154 |
---|---|
Former Name | ASHLEY ELIZABETH BODNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007662) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007662) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-09-19 |
Last Update Date | 2025-07-16 |