NPI | 1811456213 |
---|---|
Former Name | JORI PONDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95028126) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95057069) |
Enumeration Date | 2019-03-15 |
Last Update Date | 2023-11-27 |