| NPI | 1194418988 |
|---|---|
| Former Name | KATHERINE ELIZABETH MCCORMACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023017608) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-10-16 |