| NPI | 1912981143 |
|---|---|
| Former Name | KATRINA DENISE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 3469) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: PA MA064316) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA3712) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2024-03-07 |