NPI | 1245502483 |
---|---|
Former Name | KATIE JO PERPICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO MSPA.0000004) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10941) |
363A00000X Physician Assistant (Licence: AZ 5217) | |
363A00000X Physician Assistant (Licence: NC 0010-06359) | |
Enumeration Date | 2012-02-03 |
Last Update Date | 2021-09-21 |