NPI | 1396296331 |
---|---|
Former Name | MARY RISINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023020074) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2016036971) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2023-06-28 |