NPI | 1508379405 |
---|---|
Former Name | DENISE C BERGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8454) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 8454) |
Enumeration Date | 2017-11-14 |
Last Update Date | 2024-06-18 |