| NPI | 1679171367 |
|---|---|
| Former Name | MARIA CHRISTINE THACKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61099325) |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2023-02-16 |