NPI | 1568086239 |
---|---|
Former Name | KATHLEEN HEATH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2012001089) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-05-29 |
Last Update Date | 2024-09-26 |