NPI | 1982678264 |
---|---|
Former Name | LISA JANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000239) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 0239) |
Enumeration Date | 2006-02-14 |
Last Update Date | 2019-06-10 |