NPI | 1487801817 |
---|---|
Former Name | KRISTY ROSE ABDOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19601) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200441107RN) |
Enumeration Date | 2008-08-27 |
Last Update Date | 2019-09-10 |