| NPI | 1063046811 |
|---|---|
| Former Name | CASSANDRA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021046796) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0055770) |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0001394) | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2021-12-20 |