NPI | 1700836673 |
---|---|
Former Name | SPRING A BOEDDEKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R33815) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 194077-4) |
363LF0000X Nurse Practitioner, Family (Licence: MN CNP 3591) | |
Enumeration Date | 2006-05-11 |
Last Update Date | 2024-02-21 |