NPI | 1376675231 |
---|---|
Former Name | CHARLENE HOLBROOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 344943-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 3449438900) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2022-06-27 |