| NPI | 1902104300 |
|---|---|
| Former Name | KARIE MARGARET BANACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 18578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209004397) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2015-12-21 |