NPI | 1619520202 |
---|---|
Former Name | AUTUMN NICOLE WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 24030) |
Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: SC 109747) |
Enumeration Date | 2019-07-23 |
Last Update Date | 2021-10-22 |