NPI | 1336733120 |
---|---|
Former Name | SALLY BEARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010986A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28226105A) |
Enumeration Date | 2021-02-23 |
Last Update Date | 2022-10-05 |