| NPI | 1477970796 |
|---|---|
| Former Name | ALLISON SOURK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71004863A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28206970A) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2019-02-14 |