NPI | 1376242594 |
---|---|
Former Name | PAIGE ROSELEN BUELOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71013693A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28261517A) |
Enumeration Date | 2023-02-27 |
Last Update Date | 2023-03-31 |