| NPI | 1588769913 |
|---|---|
| Former Name | CAROLYN S AVAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000785A) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-02-11 |