NPI | 1770922098 |
---|---|
Former Name | MARY ROSE BUSCHOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95000723) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F338010-1) |
Enumeration Date | 2013-06-19 |
Last Update Date | 2020-05-29 |