| NPI | 1851716823 |
|---|---|
| Former Name | KAITLYN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056745) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056746) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056746) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2024-08-27 |