NPI | 1982602751 |
---|---|
Former Name | TERRY L. WENNERSTEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704148492) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704148492) |
Enumeration Date | 2005-07-14 |
Last Update Date | 2010-05-27 |