NPI | 1154657625 |
---|---|
Former Name | KATRICE DIONNE BERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-173899) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 186422) |
Enumeration Date | 2009-10-19 |
Last Update Date | 2022-09-29 |