NPI | 1497792485 |
---|---|
Former Name | LISA MONICA MALBURG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704173236) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704173236) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2018-12-03 |