NPI | 1245983840 |
---|---|
Former Name | KATIE C ODVODY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2705) |
Enumeration Date | 2022-02-02 |
Last Update Date | 2024-07-03 |