NPI | 1023522737 |
---|---|
Former Name | ALISON PORCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23546) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012460) |
Enumeration Date | 2017-11-17 |
Last Update Date | 2018-12-31 |