| NPI | 1023534724 |
|---|---|
| Former Name | KATELYN ELIZABETH LIPPERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111238) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA059176) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2020-09-01 |