| NPI | 1376191312 |
|---|---|
| Former Name | KATHLEEN KAYE DEVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1021237) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: OR 201709498RN) |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2022-01-24 |