NPI | 1861902835 |
---|---|
Former Name | KAITLIN MAE TORRES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12096) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12096) |
363A00000X Physician Assistant (Licence: NM PA2017-0094) | |
Enumeration Date | 2017-10-04 |
Last Update Date | 2023-09-28 |