NPI | 1285971838 |
---|---|
Former Name | TABETHA BOVAYE RALPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 005231) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005231) |
Enumeration Date | 2013-01-15 |
Last Update Date | 2024-03-06 |