NPI | 1346848918 |
---|---|
Former Name | DEVON MARIE PONDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 107740) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 107740) |
Enumeration Date | 2020-10-15 |
Last Update Date | 2020-10-15 |