| NPI | 1851676985 |
|---|---|
| Former Name | MARY KATHERINE DULLEA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055335) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA055335) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2023-09-27 |