| NPI | 1922557859 |
|---|---|
| Former Name | KATELYN ROSE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH EL10478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5924) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2022-10-18 |