NPI | 1508411281 |
---|---|
Former Name | ALYSSA ROSE DREGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003472) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11003472) |
Enumeration Date | 2019-08-08 |
Last Update Date | 2019-08-08 |