NPI | 1336121367 |
---|---|
Former Name | MELANIE CAROL HOGBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002345) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002345) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2016-06-30 |