NPI | 1740848019 |
---|---|
Former Name | ELIZABETH LOUISE KROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 312690) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008930) |
363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008930) | |
Enumeration Date | 2019-06-03 |
Last Update Date | 2025-01-14 |