| NPI | 1457609828 |
|---|---|
| Former Name | ALICIA MARIE CALLAIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN107124) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-10-10 |