NPI | 1437502739 |
---|---|
Former Name | LISA WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2016028514) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-77700-041) |
Enumeration Date | 2016-07-21 |
Last Update Date | 2023-07-26 |