NPI | 1073913604 |
---|---|
Former Name | CHRIS E WANGARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5986) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 5986) |
Enumeration Date | 2014-09-02 |
Last Update Date | 2023-10-03 |