| NPI | 1497168041 |
|---|---|
| Former Name | BROOKE MARIE MCGOVERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376259101) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-111661-101) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-12-04 |