NPI | 1336144559 |
---|---|
Former Name | MARIJANE SARAH WOHLLEB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3004812) |
Additional Taxonomies | 174400000X Specialist (Licence: IN 7100790) |
Enumeration Date | 2005-06-15 |
Last Update Date | 2017-03-28 |