| NPI | 1215641071 |
|---|---|
| Former Name | KATIE IRENE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024186013) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |