| NPI | 1417205477 |
|---|---|
| Other Name | KATHLEEN ANN BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-08-24 |
| Last Update Date | 2012-08-24 |