NPI | 1720090400 |
---|---|
Former Name | CAROLYN J BELLAMAH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-100490) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 27917) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2024-01-29 |