NPI | 1558870600 |
---|---|
Former Name | MALIA VANNATTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: HI 2326) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI 2326) |
Enumeration Date | 2017-09-20 |
Last Update Date | 2023-02-13 |