NPI | 1801270350 |
---|---|
Former Name | KATHRYN E. BRUCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 075139-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2291390) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2022-01-20 |