| NPI | 1134744220 |
|---|---|
| Former Name | KAITLYN MICHELLE HOLBROOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3604) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2022-03-02 |