| NPI | 1538498100 |
|---|---|
| Former Name | CARMEN JEAN COAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002828) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002828) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2022-02-04 |