| NPI | 1801194972 |
|---|---|
| Former Name | KATRINA D. BROOMFIELD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110311) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004612) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2021-08-06 |