| NPI | 1225385487 |
|---|---|
| Former Name | ASHLEY BLAIR VAN LARE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4919) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 161460-30) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2024-09-09 |