NPI | 1033307780 |
---|---|
Former Name | JUSTINE HOLLE DAMMERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 364SX0204X Clinical Nurse Specialist, Oncology, Pediatrics (Licence: IL 209-006692) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-006692) |
Enumeration Date | 2007-10-09 |
Last Update Date | 2020-12-08 |