NPI | 1962557470 |
---|---|
Former Name | KATHERINE MARIE BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002902) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000790) |
363A00000X Physician Assistant (Licence: AL PA-591) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2015-06-26 |