NPI | 1124096193 |
---|---|
Former Name | SHAUNA E POE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001969A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001969A) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2023-11-17 |