NPI | 1376927996 |
---|---|
Former Name | LAURA WACHTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011413) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP015251) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP015251) | |
364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: PA RN616052) | |
Enumeration Date | 2015-07-14 |
Last Update Date | 2023-08-07 |