NPI | 1568700409 |
---|---|
Former Name | BARBARA MARIANNE ILLGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 681099) |
Enumeration Date | 2013-01-28 |
Last Update Date | 2013-01-28 |