NPI | 1659489920 |
---|---|
Former Name | KATIE COLLEEN ROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04430) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04430) |
Enumeration Date | 2006-08-28 |
Last Update Date | 2024-08-27 |