NPI | 1477141729 |
---|---|
Former Name | MARY KLOOTWYK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71011007A) |
Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: IN 28170191A) |
363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011007A) | |
Enumeration Date | 2021-01-04 |
Last Update Date | 2022-12-16 |