NPI | 1679002091 |
---|---|
Former Name | LINDSAY ANN WADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704296127) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704296127) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2022-07-21 |