NPI | 1669912457 |
---|---|
Former Name | LUISA WONDRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN328484) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9258834) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN9258834) | |
Enumeration Date | 2017-02-28 |
Last Update Date | 2024-06-20 |