NPI | 1225006588 |
---|---|
Former Name | RAMONA BRANDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9347155) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004009716) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2012-12-06 |