NPI | 1427720457 |
---|---|
Former Name | CHRISTINA TRELLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: ID 69890) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID AG09210173) |
Enumeration Date | 2021-09-28 |
Last Update Date | 2024-02-14 |