NPI | 1740702893 |
---|---|
Former Name | ELAINA NICOLE COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 0005027) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0005027) |
Enumeration Date | 2017-07-11 |
Last Update Date | 2023-09-16 |