NPI | 1912558446 |
---|---|
Former Name | KATIE DULLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019037093) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019037093) |
Enumeration Date | 2019-09-25 |
Last Update Date | 2022-02-02 |