NPI | 1609212257 |
---|---|
Former Name | KATHLEEN WALLACH SCHMIEGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 277.000970) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 1982958013) |
363L00000X Nurse Practitioner (Licence: IL 277.000970) | |
Enumeration Date | 2013-05-21 |
Last Update Date | 2024-02-16 |