| NPI | 1659814226 |
|---|---|
| Former Name | KATHRYN BAGLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024173266) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001225897) |
| 208800000X Urology (Licence: VA 0024173266) | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2023-08-10 |