NPI | 1649378647 |
---|---|
Former Name | KATHLEEN A DIEKHOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 28150969) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002214) |
363LN0000X Nurse Practitioner, Neonatal (Licence: GA RN311453) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2022-08-11 |