NPI | 1295177848 |
---|---|
Other Name | STACI KRISANN SPAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: NC 5006345) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006345) |
Enumeration Date | 2013-07-24 |
Last Update Date | 2023-10-17 |