| NPI | 1811588494 |
|---|---|
| Former Name | KATLYN ANN BOBOS |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004281A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 085009225) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-07-11 |