| NPI | 1578946612 |
|---|---|
| Former Name | KATHERINE TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MS PA00464) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200837) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-11-01 |