NPI | 1053577163 |
---|---|
Former Name | MARIANNE ERVIN VESTERFELT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704195880) |
Enumeration Date | 2008-07-29 |
Last Update Date | 2021-05-03 |