NPI | 1497724835 |
---|---|
Former Name | DENISE MARIE BAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704169638) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 1162) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704169638) | |
Enumeration Date | 2006-03-17 |
Last Update Date | 2011-09-15 |