NPI | 1689924359 |
---|---|
Former Name | ALLISON ULRICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004802) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006421) |
363A00000X Physician Assistant (Licence: CO 0004802) | |
Enumeration Date | 2012-09-10 |
Last Update Date | 2023-10-18 |