| NPI | 1912561226 |
|---|---|
| Former Name | KATIE SUZANNE ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9898) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 1650) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2020-11-30 |