NPI | 1073630257 |
---|---|
Former Name | ANGELA MAE REAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 3394) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 20040001-22) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2013-03-11 |