NPI | 1588997407 |
---|---|
Former Name | HEATHER HELENA TELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA #19023#646731) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 19023) |
Enumeration Date | 2009-09-09 |
Last Update Date | 2012-02-02 |