| NPI | 1619461357 | 
|---|---|
| Former Name | KATI ANN RUBALCAVA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A127769)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A127769)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA A127769)  | |
| Enumeration Date | 2018-06-17 | 
| Last Update Date | 2023-01-30 |