NPI | 1487636932 |
---|---|
Former Name | ELIZABETH ANN FUNKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 11294) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 413322) |
Enumeration Date | 2005-11-18 |
Last Update Date | 2016-09-30 |