NPI | 1134651276 |
---|---|
Former Name | MARKETTA ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 296931) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A005111) |
Enumeration Date | 2017-03-29 |
Last Update Date | 2025-01-15 |