| NPI | 1912269168 |
|---|---|
| Former Name | KATHLEEN ANN VON ORDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD195295) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1250) |
| 207Q00000X Family Medicine (Licence: AZ 50221) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2020-06-01 |