NPI | 1639316003 |
---|---|
Former Name | ALYSSA JUNE BOSWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 991898) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 179969) |
Enumeration Date | 2009-01-07 |
Last Update Date | 2024-05-17 |