NPI | 1831556018 |
---|---|
Former Name | CHARLA CANDACE WAUQUA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 212001) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK r0080885) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2024-09-16 |