| NPI | 1780299123 |
|---|---|
| Former Name | EMILY LAUREN KETTERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP022466) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022466) |
| Enumeration Date | 2020-09-12 |
| Last Update Date | 2024-06-28 |