NPI | 1396454021 |
---|---|
Professional Name | BRENDA MUTEHART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 209026643) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 00000000000000000000) |
Enumeration Date | 2022-11-21 |
Last Update Date | 2023-08-23 |