NPI | 1053762757 |
---|---|
Former Name | DANIELLE FUSSELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002161) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95024945) |
Enumeration Date | 2016-06-24 |
Last Update Date | 2024-05-09 |