NPI | 1598239881 |
---|---|
Former Name | SHELBY POLAKOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021487) |
Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: AZ RN170813) |
363LF0000X Nurse Practitioner, Family (Licence: AZ 229089) | |
Enumeration Date | 2019-01-19 |
Last Update Date | 2022-09-06 |