| NPI | 1154991958 |
|---|---|
| Former Name | KATELYN ANN CROTHERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12355) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12355) |
| 363AS0400X Physician Assistant, Surgical (Licence: WI 5458-23) | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2024-01-26 |