NPI | 1174135321 |
---|---|
Former Name | KATHRYN ANN LIBUSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95029499) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 833635) |
Enumeration Date | 2020-08-19 |
Last Update Date | 2024-03-23 |