NPI | 1548709595 |
---|---|
Former Name | ALEXIS ELIZABETH HOLLAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F342624-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701260) |
163W00000X Registered Nurse (Licence: CT 134169) | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2018-08-14 |