NPI | 1336587831 |
---|---|
Former Name | THERESA L PERCY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041.296842) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.296842) |
Enumeration Date | 2013-06-06 |
Last Update Date | 2013-06-11 |