NPI | 1528356300 |
---|---|
Former Name | AMY JEANNE BOTTKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MN CNP4723) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: TX AP132938) |
Enumeration Date | 2011-07-14 |
Last Update Date | 2021-11-02 |