| NPI | 1821427345 |
|---|---|
| Former Name | KATHLEEN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 194120) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 5589-33) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2017-01-05 |