NPI | 1851553721 |
---|---|
Former Name | DANA KINGMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004048A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28202357A) |
363L00000X Nurse Practitioner (Licence: IN 71004048A) | |
Enumeration Date | 2008-07-01 |
Last Update Date | 2022-07-26 |