NPI | 1407385479 |
---|---|
Former Name | ALLISON I MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP017832) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP017832) |
Enumeration Date | 2017-06-05 |
Last Update Date | 2020-09-01 |