NPI | 1790063246 |
---|---|
Former Name | ALYSON BLYTHE HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9265545) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704346884) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2022-04-01 |