| NPI | 1023642949 |
|---|---|
| Former Name | KATIE MICHELLE GUNNARE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008991) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-29 |
| Last Update Date | 2023-02-20 |