NPI | 1972967305 |
---|---|
Former Name | ROBERTA MATHESIUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60632722) |
Enumeration Date | 2016-04-12 |
Last Update Date | 2016-04-12 |