NPI | 1477914885 |
---|---|
Former Name | JANAE ROBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013948) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016006756) |
Enumeration Date | 2016-03-11 |
Last Update Date | 2024-08-27 |