| NPI | 1760497283 |
|---|---|
| Former Name | MARY VANDERHOOF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA597) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA597) |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA597) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2025-08-28 |