NPI | 1568074359 |
---|---|
Former Name | JAMIE KIVISTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9898) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9898-33) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2024-05-06 |