| 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 |