| NPI | 1760881056 |
|---|---|
| Former Name | KAITLIN INGHRAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IA 133152) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 133152) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085-005117) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 2571) | |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2025-08-21 |