NPI | 1568852697 |
---|---|
Former Name | MAY ELIZABETH PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WA AP60371254) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP60371254) |
Enumeration Date | 2015-01-27 |
Last Update Date | 2015-01-27 |