NPI | 1154953099 |
---|---|
Former Name | TAMARA D METTLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209027013) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28249915A) |
363L00000X Nurse Practitioner (Licence: IN 71009794A) | |
Enumeration Date | 2020-02-09 |
Last Update Date | 2024-12-26 |