| NPI | 1457375032 |
|---|---|
| Former Name | MARISSA ANN COLYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060596) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ T-632) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-10-18 |