NPI | 1679858997 |
---|---|
Former Name | KATY GRAVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01486) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01486) |
363AM0700X Physician Assistant, Medical (Licence: NE 1697) | |
363AS0400X Physician Assistant, Surgical (Licence: NE 1697) | |
Enumeration Date | 2011-10-18 |
Last Update Date | 2013-05-22 |