| NPI | 1578227211 |
|---|---|
| Former Name | MARY KATHLEEN PUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 13987) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2024-11-05 |