NPI | 1194248203 |
---|---|
Former Name | BARBARA B BROBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5812) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 7896-33) |
Enumeration Date | 2017-07-20 |
Last Update Date | 2021-12-08 |