| NPI | 1942883541 |
|---|---|
| Former Name | KATELYN ROSE RUARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD214923) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR PG205135) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2026-06-26 |