| NPI | 1184297293 |
|---|---|
| Former Name | MARISA WEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP024131) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN696220) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-10-13 |