| NPI | 1730474180 |
|---|---|
| Former Name | CHANDRA R. GREENLEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001275A) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-02-04 |