NPI | 1194720797 |
---|---|
Former Name | CAITLYN GRAHAM BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9111020) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA111020) |
363A00000X Physician Assistant (Licence: FL PA91111020) | |
363AM0700X Physician Assistant, Medical (Licence: IN 10000698A) | |
363AS0400X Physician Assistant, Surgical (Licence: IN 10000698A) | |
363AS0400X Physician Assistant, Surgical (Licence: IN 10000698) | |
Enumeration Date | 2005-06-20 |
Last Update Date | 2020-10-26 |