Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 04-40200 | KS |
NPI | 1043553951 |
---|---|
Provider Name | Caitlin Jo Pauly |
First Address | Hutchinson, KS 67502 |
Second Address | Hutchinson, KS 67502-1131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 23/08/2021 |