NPI | 1194798488 |
---|---|
Former Name | PAULA K WILLENBORG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IA J050653) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 050653) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2019-06-28 |