| NPI | 1720616477 |
|---|---|
| Former Name | KATIE ELIZABETH BALSAMO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704361496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR18109500) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-02-09 |