NPI | 1962743633 |
---|---|
Former Name | DONNA BURGESS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP121025) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP26595) |
Enumeration Date | 2013-03-06 |
Last Update Date | 2022-01-21 |