NPI | 1295324895 |
---|---|
Former Name | SARA WINGATE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 322814) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 31353) |
363LF0000X Nurse Practitioner, Family (Licence: SC 24589) | |
Enumeration Date | 2021-01-18 |
Last Update Date | 2024-01-25 |