NPI | 1710712567 |
---|---|
Former Name | MALLORY KAELIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71015707A) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IN 71015707A) |
Enumeration Date | 2024-09-03 |
Last Update Date | 2024-10-17 |