NPI | 1548669724 |
---|---|
Former Name | PATRICIA LEROY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 89028-30) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 89028) |
Enumeration Date | 2014-08-14 |
Last Update Date | 2014-08-14 |