| NPI | 1548598386 |
|---|---|
| Former Name | COLLEEN NELL KIRBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004272) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054155) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2017-08-31 |