| NPI | 1811371479 |
|---|---|
| Former Name | CAROLINE ANNE COLSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3573-23) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2022-07-21 |