NPI | 1154782712 |
---|---|
Former Name | GLORIA FRITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 21016) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 203408) |
Enumeration Date | 2016-03-10 |
Last Update Date | 2017-05-22 |