NPI | 1912416413 |
---|---|
Former Name | HEATHER ANN GRUNDHAUSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID 66533) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ID 66533) |
Enumeration Date | 2017-09-27 |
Last Update Date | 2022-07-21 |