NPI | 1104177989 |
---|---|
Former Name | MARISSA CHRISTINE BURCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OR 201250151NP) |
Enumeration Date | 2012-09-20 |
Last Update Date | 2013-10-29 |