NPI | 1811352909 |
---|---|
Former Name | KAITLYN ANN NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA55730) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-12-16 |
Last Update Date | 2018-09-25 |