NPI | 1124635446 |
---|---|
Former Name | TORI CRABTREE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014938) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 0306350) |
363LF0000X Nurse Practitioner, Family (Licence: OH 0027691) | |
Enumeration Date | 2020-09-30 |
Last Update Date | 2022-02-28 |