NPI | 1548463664 |
---|---|
Former Name | MARY D BERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F334409) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F334409) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2021-01-07 |