| NPI | 1033455266 |
|---|---|
| Former Name | KATHERINE ANN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4616) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 2210) |
| Enumeration Date | 2012-12-15 |
| Last Update Date | 2018-02-21 |