NPI | 1861027682 |
---|---|
Former Name | KATHLEEN MARIE WILMINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 24181323) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 89288) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2024-09-27 |