NPI | 1457684862 |
---|---|
Former Name | KARA ANN CALLAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002342) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002342) |
Enumeration Date | 2009-09-16 |
Last Update Date | 2013-11-05 |