| NPI | 1255722153 |
|---|---|
| Former Name | KATHERINE MARIE SHELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3430) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085005390) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2016-12-06 |