NPI | 1871863597 |
---|---|
Former Name | SANDRIA JOAN BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11001462) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 1136932) |
163WG0600X Registered Nurse, Gerontology (Licence: FL 1136932) | |
Enumeration Date | 2012-01-11 |
Last Update Date | 2021-06-26 |