NPI | 1083968978 |
---|---|
Former Name | TAMRA R EHLTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71006229A) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-009796) |
Enumeration Date | 2012-10-31 |
Last Update Date | 2016-05-09 |