| NPI | 1083242499 |
|---|---|
| Former Name | CAITLYN KLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-06-13 |