| NPI | 1104352665 |
|---|---|
| Former Name | ERNESTINE PENVAGA FOMUNUNG-NGAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9310637) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9310637) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2021-07-27 |