| NPI | 1790245116 |
|---|---|
| Former Name | KATHERINE ELIZABETH BOURBEAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 178058) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL39) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-06-27 |