NPI | 1013415314 |
---|---|
Former Name | AMY ELIZABETH FREESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010255) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F01171044) |
Enumeration Date | 2018-02-01 |
Last Update Date | 2021-08-07 |