NPI | 1275077398 |
---|---|
Former Name | HEATHER DANIELLE STANFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-121972) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 1-121972) |
Enumeration Date | 2016-12-08 |
Last Update Date | 2022-08-10 |