NPI | 1235616269 |
---|---|
Former Name | KATHRYN L ROETHLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8598-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 168554-30) |
Enumeration Date | 2018-07-23 |
Last Update Date | 2018-08-14 |