NPI | 1477926517 |
---|---|
Former Name | MAYONNE POLLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 29423) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95003389) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95003389) | |
Enumeration Date | 2015-11-11 |
Last Update Date | 2022-03-31 |