NPI | 1255633194 |
---|---|
Former Name | MARITA AGNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2258892) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1021608) |
363LF0000X Nurse Practitioner, Family (Licence: NH 067149-21) | |
Enumeration Date | 2010-11-29 |
Last Update Date | 2014-09-26 |