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 |