NPI | 1972892693 |
---|---|
Former Name | KATHLEEN M MEDWAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201350062NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2263944) |
Enumeration Date | 2011-04-04 |
Last Update Date | 2023-07-25 |