NPI | 1902051030 |
---|---|
Former Name | KATHRYN MARY DEBORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R212570) |
Enumeration Date | 2008-11-17 |
Last Update Date | 2018-02-15 |