NPI | 1649688912 |
---|---|
Former Name | ELIZABETH ANN STAFFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R882671) |
Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: MS R882671) |
Enumeration Date | 2014-07-30 |
Last Update Date | 2020-08-13 |