| NPI | 1295056828 |
|---|---|
| Former Name | MARY R COOPER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: WI 9275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 234011-1) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MN CNP 4719) | |
| 163W00000X Registered Nurse (Licence: WI 157162-30) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-02-07 |