NPI | 1639755747 |
---|---|
Former Name | HEATHER WHITING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 209022824) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209022824) |
363LF0000X Nurse Practitioner, Family (Licence: IA A162114) | |
Enumeration Date | 2021-03-19 |
Last Update Date | 2025-02-06 |