| NPI | 1295518363 |
|---|---|
| Former Name | KATRINA MARIE THORMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1733062231) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1733079231) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |