| NPI | 1043777808 |
|---|---|
| Former Name | ELISE BURGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2279400) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2279400) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2024-02-12 |