NPI | 1407100381 |
---|---|
Former Name | EMILY MCREYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009892) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209009892) |
Enumeration Date | 2012-10-31 |
Last Update Date | 2022-06-09 |