NPI | 1720588866 |
---|---|
Former Name | DEBORAH WALLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9384333) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9384333) |
Enumeration Date | 2018-02-15 |
Last Update Date | 2023-02-06 |