NPI | 1861901720 |
---|---|
Former Name | MARY KATE HALDEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3425) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 3425) |
Enumeration Date | 2017-09-22 |
Last Update Date | 2023-11-02 |