NPI | 1679131031 |
---|---|
Former Name | JANEA A THALER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 34837) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11002742) |
Enumeration Date | 2019-05-31 |
Last Update Date | 2024-01-31 |