NPI | 1669620191 |
---|---|
Former Name | LEILA SHARVANI HANAGUD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0001930) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0001930) |
Enumeration Date | 2008-09-09 |
Last Update Date | 2022-08-03 |