NPI | 1003312984 |
---|---|
Former Name | KATHLEEN MEERA LOPEZ KIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN256618) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN256618) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN256618) | |
Enumeration Date | 2018-04-01 |
Last Update Date | 2020-01-22 |