NPI | 1982052510 |
---|---|
Former Name | RENAIE LEBLOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005625) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 23.003694) |
Enumeration Date | 2016-05-24 |
Last Update Date | 2022-03-15 |