NPI | 1114403102 |
---|---|
Former Name | CASSANDRA M COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8621-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 195907-30) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704345763) | |
Enumeration Date | 2018-07-13 |
Last Update Date | 2019-12-30 |