NPI | 1457720724 |
---|---|
Former Name | MARY KATELYNN HARDIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2024) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002217A) |
Enumeration Date | 2015-09-17 |
Last Update Date | 2018-08-03 |