NPI | 1124436118 |
---|---|
Former Name | PAMELA SUE WILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5944-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 143303-30) |
Enumeration Date | 2014-07-23 |
Last Update Date | 2021-08-25 |