NPI | 1962525840 |
---|---|
Former Name | MARY ANN MITZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: SD CP000097) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD R014468) |
Enumeration Date | 2007-04-07 |
Last Update Date | 2011-10-14 |