NPI | 1356697726 |
---|---|
Former Name | MYKALE R HOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012026932) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2008022802) |
Enumeration Date | 2012-08-03 |
Last Update Date | 2013-04-15 |