| NPI | 1992111710 |
|---|---|
| Former Name | KATELYN MARIE MERANDO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-39487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014020085) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2022-07-21 |