NPI | 1659057701 |
---|---|
Former Name | BROOKE SAWYER ANGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5018310) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5018310) |
Enumeration Date | 2023-06-23 |
Last Update Date | 2024-06-11 |