NPI | 1326558503 |
---|---|
Former Name | CHARISSA BOHNBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018178) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: PA RN600680) |
Enumeration Date | 2017-10-02 |
Last Update Date | 2018-02-19 |