| NPI | 1538428297 |
|---|---|
| Former Name | MARLENE ROBERTA DIETRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0100X Registered Nurse, Gastroenterology (Licence: MI 4704261155) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |