NPI | 1649240938 |
---|---|
Former Name | HOLLY J WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 80303) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R134082-4) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2020040251) | |
Enumeration Date | 2006-01-26 |
Last Update Date | 2024-06-05 |