NPI | 1275967549 |
---|---|
Former Name | KATHERINE JUNE MALONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51616) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016852) |
Enumeration Date | 2013-08-22 |
Last Update Date | 2015-03-17 |