NPI | 1285880856 |
---|---|
Former Name | KRISTINE M BROGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 134341) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 134341) |
Enumeration Date | 2008-08-14 |
Last Update Date | 2020-08-07 |