NPI | 1063132595 |
---|---|
Former Name | EMILY KATHERINE THIELE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025891) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041408114) |
Enumeration Date | 2022-09-02 |
Last Update Date | 2022-09-02 |