| NPI | 1285192385 |
|---|---|
| Former Name | KATHERINE M ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209019126) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019126) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2024-11-07 |