NPI | 1871371930 |
---|---|
Former Name | KATELYN N POLLEMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028535) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028535) |
Enumeration Date | 2023-09-20 |
Last Update Date | 2024-01-09 |