NPI | 1790304012 |
---|---|
Former Name | JESSICA HATCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MD R254008) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA GA268600) |
Enumeration Date | 2020-04-16 |
Last Update Date | 2022-11-02 |