NPI | 1700289378 |
---|---|
Former Name | KATHINA SHEETS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01227) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3373) |
363A00000X Physician Assistant (Licence: MA PA7576) | |
Enumeration Date | 2014-09-26 |
Last Update Date | 2020-07-02 |