| NPI | 1396599932 | 
|---|---|
| Former Name | CARLY JANE BURGER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71015489A) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28210211A) | 
| Enumeration Date | 2024-04-11 | 
| Last Update Date | 2024-10-03 |