| NPI | 1902366966 |
|---|---|
| Former Name | KATHRYN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 279871) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2019-07-08 |