NPI | 1013253871 |
---|---|
Former Name | MARY ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11005295) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NC 5007226) |
Enumeration Date | 2012-12-26 |
Last Update Date | 2020-09-02 |