NPI | 1396453346 |
---|---|
Other Name | MELINDA SUE GANGLOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL AG09220121) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209027429) |
Enumeration Date | 2022-11-08 |
Last Update Date | 2025-05-13 |