NPI | 1588746366 |
---|---|
Former Name | KATHRYN MICHELLE PUTNAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2005001379) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1500996) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2015-06-29 |