| NPI | 1124477195 |
|---|---|
| Other Name | KATHERINE ELIZABETH EDSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2016026678) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01970) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-09-23 |