NPI | 1285722942 |
---|---|
Former Name | JESSICA ROSE MANKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 548205) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 10442) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2016-10-24 |