NPI | 1205457793 |
---|---|
Former Name | KATHERINE ELIZABETH TYLER MCGOWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS022272) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT020030) |
Enumeration Date | 2020-05-06 |
Last Update Date | 2024-07-08 |