NPI | 1497426290 |
---|---|
Former Name | ELIZABETH ANNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209023091) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023091) |
Enumeration Date | 2021-09-22 |
Last Update Date | 2024-10-22 |