NPI | 1699234310 |
---|---|
Former Name | ANDREA ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 201912762) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6509) |
Enumeration Date | 2019-03-13 |
Last Update Date | 2024-10-14 |