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 |