NPI | 1174057988 |
---|---|
Former Name | KATHLEEN ELIZABETH CORWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60771610) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA RN60744309) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2017-06-23 |