NPI | 1669439758 |
---|---|
Former Name | KATHERINE MARIE GRINENKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704190296) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN278072) |
363L00000X Nurse Practitioner (Licence: OH COANP06837) | |
363L00000X Nurse Practitioner (Licence: OH RX06837) | |
Enumeration Date | 2006-05-01 |
Last Update Date | 2019-03-25 |