| NPI | 1427466150 |
|---|---|
| Former Name | KATHERINE CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 3995) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA5048) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2023-01-05 |