NPI | 1942675673 |
---|---|
Former Name | SHEENA D HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.013806) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022003791) |
Enumeration Date | 2015-12-07 |
Last Update Date | 2024-08-28 |