NPI | 1902177850 |
---|---|
Former Name | DIANE MARIE PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61312337) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60085467) |
Enumeration Date | 2012-01-24 |
Last Update Date | 2022-10-05 |