| NPI | 1922459650 |
|---|---|
| Former Name | KATHRYN CORGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062485) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085006150) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 3760-23) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2022-05-10 |