NPI | 1134814742 |
---|---|
Former Name | KRISTEN M GOETZKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13889) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 254572) |
Enumeration Date | 2023-04-10 |
Last Update Date | 2023-08-07 |