NPI | 1053866921 |
---|---|
Former Name | AMY WETZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006471A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71006471A) |
Enumeration Date | 2016-08-22 |
Last Update Date | 2024-10-03 |