NPI | 1417618190 |
---|---|
Former Name | ABIGAIL L PECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209030207) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348969) |
Enumeration Date | 2022-01-05 |
Last Update Date | 2024-09-24 |