NPI | 1104339225 |
---|---|
Former Name | MARIA AGNES AUSTRIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 818910) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 793972) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95007503) | |
Enumeration Date | 2017-11-11 |
Last Update Date | 2022-10-20 |