NPI | 1831117647 |
---|---|
Former Name | JANE K. ROETTGER(MAIDEN NAME) |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 140451) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 140451) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2017-01-12 |