NPI | 1144360371 |
---|---|
Former Name | LANA DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 142877) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 142877) |
Enumeration Date | 2007-02-07 |
Last Update Date | 2017-03-06 |