NPI | 1700398666 |
---|---|
Former Name | TABATHA COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009930A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28186169A) |
363L00000X Nurse Practitioner (Licence: IN 71009930A) | |
Enumeration Date | 2017-11-01 |
Last Update Date | 2025-02-12 |