NPI | 1376318782 |
---|---|
Former Name | BETSY VANDAMME |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014850A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28167335A) |
Enumeration Date | 2023-11-16 |
Last Update Date | 2024-01-25 |