NPI | 1912798471 |
---|---|
Former Name | ALISHA POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009122) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 66368) |
363A00000X Physician Assistant (Licence: NM PA2025-0044) | |
Enumeration Date | 2025-05-14 |
Last Update Date | 2025-05-14 |