| NPI | 1417164161 |
|---|---|
| Former Name | KATHY ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR OR MD19016) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA WA MD00040718) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |