NPI | 1982139085 |
---|---|
Former Name | KATHLEEN AMBER KEARNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: KY 05130) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 05130) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-26 |
Last Update Date | 2022-04-13 |