NPI | 1841524501 |
---|---|
Former Name | KATHLEEN MARIE SWIFT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 25419) |
363AM0700X Physician Assistant, Medical (Licence: GA 1949) | |
Enumeration Date | 2009-09-29 |
Last Update Date | 2023-07-03 |