| NPI | 1780850966 |
|---|---|
| Former Name | KATHLEEN MAHL BOOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA RN076670 AP05454) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2010-05-17 |