NPI | 1255747325 |
---|---|
Former Name | KATHRYN GRACE LEITERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5881-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 138209-30) |
Enumeration Date | 2014-07-09 |
Last Update Date | 2019-12-31 |