| NPI | 1710657861 |
|---|---|
| Former Name | MARY KATE GOODMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN236683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN236683) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-12-21 |