NPI | 1336660737 |
---|---|
Former Name | JESSI RAE ENO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP017784) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP017784) |
Enumeration Date | 2017-07-06 |
Last Update Date | 2019-11-04 |