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 |