NPI | 1962927327 |
---|---|
Former Name | AYANNA AKOSUA SMALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006192) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 661631) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2017-10-02 |