NPI | 1336446806 |
---|---|
Former Name | FLORA ANTIWI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10705-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 170032-30) |
363L00000X Nurse Practitioner (Licence: WI 10705-33) | |
Enumeration Date | 2011-02-18 |
Last Update Date | 2024-07-03 |