NPI | 1487384665 |
---|---|
Former Name | KATHRYN REBECCA HANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003873A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-06-12 |
Last Update Date | 2023-10-09 |