| NPI | 1306811419 |
|---|---|
| Former Name | DIANNE E WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164048) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2313205) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-04-12 |