NPI | 1891914511 |
---|---|
Former Name | CARALEE HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA2028) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 0598) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2018-08-13 |