| NPI | 1447561899 |
|---|---|
| Former Name | KAREN ANNE COGSWELL BOLDUC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA152196) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA152196) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2015-01-26 |