NPI | 1720575467 |
---|---|
Former Name | ALISA MYERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A005798) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AR A005798) |
163W00000X Registered Nurse (Licence: AR R069486) | |
Enumeration Date | 2018-04-18 |
Last Update Date | 2025-05-13 |