| NPI | 1609282870 |
|---|---|
| Former Name | ANNE MARIE CARLSONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 003127) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 003127) |
| 363AS0400X Physician Assistant Surgical (Licence: CT 003127) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2018-03-17 |