| NPI | 1699111278 |
|---|---|
| Former Name | KATHERINE LAINE SHOUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301507641) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191523) |
| 208600000X Surgery (Licence: NC 2016-01753) | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2022-07-25 |