NPI | 1013942473 |
---|---|
Former Name | TAMMY LEA ARCHIBALD/CEBALLOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 3311522) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2023-05-05 |