NPI | 1639594773 |
---|---|
Former Name | TESSA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71004834A) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71004834A) |
Enumeration Date | 2014-02-26 |
Last Update Date | 2022-08-08 |