NPI | 1811106222 |
---|---|
Former Name | ELLEN GUNDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP 9373273) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 300456) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2014-04-14 |