NPI | 1164055109 |
---|---|
Former Name | KARISSA KEAGAN JUNGERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 7120828-4405) |
Enumeration Date | 2020-02-18 |
Last Update Date | 2024-06-02 |