NPI | 1477206563 |
---|---|
Former Name | MARY CATHLEEN VON BURG BENEFEITO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 570291) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95020919) |
363L00000X Nurse Practitioner (Licence: ID 72035) | |
Enumeration Date | 2022-01-30 |
Last Update Date | 2023-06-27 |