NPI | 1386332716 |
---|---|
Former Name | KATHARINA LYNN STAATS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71013753A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28226012A) |
Enumeration Date | 2023-04-25 |
Last Update Date | 2023-10-19 |