NPI | 1861772907 |
---|---|
Former Name | CATHERINE TA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3254) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03060) |
Enumeration Date | 2011-08-21 |
Last Update Date | 2016-12-13 |