NPI | 1437793056 |
---|---|
Former Name | KATRINA ANN OVERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1539) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02365) |
363A00000X Physician Assistant (Licence: VT 055.0031443) | |
Enumeration Date | 2019-11-06 |
Last Update Date | 2020-10-16 |