| NPI | 1922525518 |
|---|---|
| Former Name | JAMIE ELIZABETH WALDORF |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-127183) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT NUR-APRN-LIC-127183) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2024-12-04 |