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 |