| 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 |