| NPI | 1841777190 |
|---|---|
| Former Name | KATELYN S REISENAUER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA007090) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059802) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-11-26 |