NPI | 1508476763 |
---|---|
Former Name | ERMA MAGNUSSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178032) |
Enumeration Date | 2020-08-03 |
Last Update Date | 2023-06-13 |