| NPI | 1043748189 |
|---|---|
| Former Name | KATHLEEN M KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 193346) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-08-10 |