NPI | 1528083342 |
---|---|
Former Name | REGINA ANSBRO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209006015) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-006015) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2023-05-03 |