NPI | 1114266541 |
---|---|
Former Name | BROOKE E. BONOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007817) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007817) |
363LF0000X Nurse Practitioner, Family (Licence: OH 330723) | |
Enumeration Date | 2013-02-05 |
Last Update Date | 2023-08-01 |