| NPI | 1437589504 |
|---|---|
| Former Name | JAIMIE ANN COLICA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7886) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363A00000X Physician Assistant (Licence: NC 0010-10729) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2023-03-07 |