NPI | 1346788973 |
---|---|
Former Name | KATELYN DUFOUR O'BRIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2343965) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60730651) |
Enumeration Date | 2017-02-02 |
Last Update Date | 2021-04-02 |