| NPI | 1073635082 |
|---|---|
| Former Name | MARY KATHERINE FLAVIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 109258) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 44561) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-07-21 |