NPI | 1265737738 |
---|---|
Former Name | MARY C MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP125799) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.008335) |
Enumeration Date | 2011-01-14 |
Last Update Date | 2019-09-10 |