NPI | 1467701664 |
---|---|
Former Name | AMANDA IRIS VERCOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ TEMP281408) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN172540) |
Enumeration Date | 2012-09-04 |
Last Update Date | 2023-07-10 |