NPI | 1821643123 |
---|---|
Former Name | KAILEEN ELIZABETH HEALY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007374) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007199) |
Enumeration Date | 2019-08-05 |
Last Update Date | 2025-07-15 |