NPI | 1144613944 |
---|---|
Former Name | KATHERINE MCGILLIVRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00542400) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003521) |
363AM0700X Physician Assistant, Medical (Licence: PA MA057488) | |
Enumeration Date | 2015-03-18 |
Last Update Date | 2023-06-15 |