NPI | 1679958748 |
---|---|
Former Name | LESLIE SOUTER BLADES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307448) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 307448) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NY 307448) | |
Enumeration Date | 2015-07-29 |
Last Update Date | 2015-07-29 |