NPI | 1467888719 |
---|---|
Former Name | HEATHER RENEE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA CA21273) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21273) |
Enumeration Date | 2013-09-18 |
Last Update Date | 2017-01-09 |