| NPI | 1073536876 | 
|---|---|
| Former Name | DENISE C EKSTROM | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 876)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 0050012711)  | 
| Enumeration Date | 2006-07-25 | 
| Last Update Date | 2013-11-21 |