NPI | 1093182990 |
---|---|
Former Name | KATELYN WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057843) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-08-26 |
Last Update Date | 2022-10-18 |