| NPI | 1366895419 |
|---|---|
| Former Name | KATHERINE RUTH MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2215) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KY PA2215) |
| 363AS0400X Physician Assistant Surgical (Licence: KY PA2215) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2022-12-22 |