NPI | 1477007052 |
---|---|
Former Name | DIANE WEBSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71006635A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28097323A) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2016-10-21 |