NPI | 1285974238 |
---|---|
Former Name | MARY BOETTCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4855) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP4855) |
Enumeration Date | 2013-02-27 |
Last Update Date | 2024-11-12 |