NPI | 1013568724 |
---|---|
Former Name | AMBER DAWN PETTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71009345A) |
Additional Taxonomies | 208600000X Surgery (Licence: IN 71009345A) |
Enumeration Date | 2019-09-24 |
Last Update Date | 2022-05-31 |