NPI | 1619323292 |
---|---|
Former Name | KRISTINE SUSAN HARTGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017657) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN562007) |
Enumeration Date | 2016-05-12 |
Last Update Date | 2022-07-21 |