NPI | 1194158238 |
---|---|
Former Name | MIRJAM J ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000330) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010635) |
Enumeration Date | 2013-08-13 |
Last Update Date | 2023-07-14 |