| NPI | 1669875779 |
|---|---|
| Former Name | KATHY LYN KITTLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 2-00422) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 6803058152) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |