NPI | 1801174404 |
---|---|
Former Name | KATHRYN MARIE BAUK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN272845) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 20111450) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2307499) | |
Enumeration Date | 2011-07-30 |
Last Update Date | 2023-03-07 |