NPI | 1558856898 |
---|---|
Former Name | MIRANDA ASHLEY BARBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112506) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 112506) |
Enumeration Date | 2018-06-28 |
Last Update Date | 2021-12-17 |