| 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 | 2013-11-05 |