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 |