| NPI | 1619194586 |
|---|---|
| Former Name | CAROL JANE HOLLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 10252) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 388433) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2016-05-19 |