NPI | 1750774642 |
---|---|
Former Name | LISA KIKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19330) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN19330) |
Enumeration Date | 2015-03-17 |
Last Update Date | 2024-11-08 |