NPI | 1669741732 |
---|---|
Former Name | CAROL STANLEY PFAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 073227-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN259665) |
Enumeration Date | 2011-12-20 |
Last Update Date | 2020-02-22 |