NPI | 1104585280 |
---|---|
Former Name | KATHERINE SPIDALIERE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 063987-23) |
Enumeration Date | 2021-12-15 |
Last Update Date | 2021-12-15 |