| NPI | 1487818001 |
|---|---|
| Former Name | KATIE SUE ROARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2014018696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-053486) |
| Enumeration Date | 2008-07-13 |
| Last Update Date | 2021-02-05 |