NPI | 1194131714 |
---|---|
Former Name | ANGELA JAYNE BARTOSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 30243) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11014691) |
363L00000X Nurse Practitioner (Licence: MI 4704272407) | |
Enumeration Date | 2014-07-02 |
Last Update Date | 2022-11-17 |