NPI | 1356660591 |
---|---|
Former Name | KARLA M HICKMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000516) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0000516) |
Enumeration Date | 2010-05-27 |
Last Update Date | 2010-12-20 |