| NPI | 1629826755 |
|---|---|
| Former Name | KATHLEEN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP029711) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-07-11 |