NPI | 1336507326 |
---|---|
Former Name | AMANDA OLIVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60688962) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60572710) |
Enumeration Date | 2016-02-04 |
Last Update Date | 2016-09-30 |