NPI | 1689044554 |
---|---|
Former Name | KATHRYN PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058835) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005947) |
Enumeration Date | 2015-10-05 |
Last Update Date | 2019-03-27 |