NPI | 1053770305 |
---|---|
Former Name | KATIE ELIZABETH CASTELLI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704273155) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704273155) |
Enumeration Date | 2016-02-15 |
Last Update Date | 2016-02-15 |