NPI | 1619430071 |
---|---|
Former Name | CLAIRE CREASY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005750) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005750) |
Enumeration Date | 2019-04-11 |
Last Update Date | 2019-08-16 |