NPI | 1902143787 |
---|---|
Former Name | KATRINA LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109028) |
Enumeration Date | 2013-01-14 |
Last Update Date | 2025-01-31 |