| NPI | 1750798146 |
|---|---|
| Former Name | KATHLEEN ANASTASIA BANIEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171847) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024171847) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2020-11-30 |