| NPI | 1114137197 |
|---|---|
| Former Name | CATHALENE ANN BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030457) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002395) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0003285) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2015-06-10 |