NPI | 1295928570 |
---|---|
Former Name | AKIMYO KIDADDA CHAMPION |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170178) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R178581) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5004213) | |
Enumeration Date | 2007-08-21 |
Last Update Date | 2022-11-30 |