| NPI | 1710546924 | 
|---|---|
| Former Name | KATHRYN ANESA FAULKNER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 382968)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382968)  | 
| Enumeration Date | 2019-06-11 | 
| Last Update Date | 2021-04-28 |