NPI | 1194197731 |
---|---|
Former Name | HEATHER LYNN GOODWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP015445) |
Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA MD3716339) |
Enumeration Date | 2015-10-22 |
Last Update Date | 2024-07-08 |