NPI | 1639835077 |
---|---|
Former Name | BETHANY JO EIFRID |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011832A) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71011832A) |
Enumeration Date | 2021-11-10 |
Last Update Date | 2025-05-12 |