NPI | 1629538939 |
---|---|
Former Name | MONICA DIANE EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22655) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22655) |
Enumeration Date | 2019-03-22 |
Last Update Date | 2019-03-22 |