NPI | 1073978839 |
---|---|
Former Name | ANGEL BOISSEAU, MARTIN, WAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 829703) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: AK 36717) |
Enumeration Date | 2015-12-22 |
Last Update Date | 2022-10-14 |