NPI | 1255018727 |
---|---|
Former Name | AMBER LEA BRYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187604) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-06-28 |
Last Update Date | 2023-07-25 |