NPI | 1891460622 |
---|---|
Former Name | ANDI JIN WISE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IA H174633) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R203167) |
363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024182376) | |
Enumeration Date | 2021-08-13 |
Last Update Date | 2024-06-26 |