| NPI | 1770896847 |
|---|---|
| Former Name | JAMIE KATHLEEN MATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105496) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2021-07-29 |