NPI | 1033591656 |
---|---|
Former Name | REBECCA M MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015553) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 64562) |
Enumeration Date | 2015-06-19 |
Last Update Date | 2024-03-22 |