NPI | 1104178045 |
---|---|
Former Name | CAITLIN M. REGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004008) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001435A) |
Enumeration Date | 2012-10-02 |
Last Update Date | 2019-05-17 |