NPI | 1306232459 |
---|---|
Former Name | MARI JORDON UNDERWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20514) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A004375) |
Enumeration Date | 2015-04-15 |
Last Update Date | 2022-07-21 |