NPI | 1457735896 |
---|---|
Former Name | KATRINA RENAE BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-004999) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004999) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2017-09-18 |