NPI | 1710020771 |
---|---|
Former Name | KRISTINE BEDORTHA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007661) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200650135NP) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2014-09-30 |