NPI | 1093966178 |
---|---|
Former Name | KATIE M. HABERSBRUNNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 553281) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003833) |
Enumeration Date | 2008-10-07 |
Last Update Date | 2019-01-04 |