| NPI | 1134221914 |
|---|---|
| Former Name | MARY CATHERINE MACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP3156902) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP60833339) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-10-14 |