NPI | 1932370756 |
---|---|
Other Name | JODI M WALLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP30006123) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 091000332N2-PNP-PP) |
Enumeration Date | 2008-03-19 |
Last Update Date | 2018-03-17 |