| NPI | 1922054246 |
|---|---|
| Former Name | ALICIA N CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5553) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002338) |
| 363AM0700X Physician Assistant Medical (Licence: AZ 5553) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-09-08 |