NPI | 1508531088 |
---|---|
Former Name | KIVA DA-SHAN BAUSWELL-HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704291746) |
Enumeration Date | 2021-08-16 |
Last Update Date | 2023-05-04 |