NPI | 1053749770 |
---|---|
Former Name | KATHLEEN PATRICIA O'MALLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013083) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013083) |
Enumeration Date | 2013-10-15 |
Last Update Date | 2020-08-24 |