NPI | 1376622845 |
---|---|
Former Name | MARY FRANCES FOSNOT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 5467) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001807) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2014-05-21 |