NPI | 1386205151 |
---|---|
Former Name | ANGELA BROUCKAERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704309689) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 19072180332) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2023-04-20 |