| NPI | 1922543958 |
|---|---|
| Former Name | MARA KATHLEEN TRAUTMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018000540) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2024-07-10 |