NPI | 1104184878 |
---|---|
Former Name | KATHERINE JEAN PERIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277-000567) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209009522) |
Enumeration Date | 2012-05-01 |
Last Update Date | 2021-03-03 |