NPI | 1528343811 |
---|---|
Former Name | REBECCA MACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209004318) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209004318) |
Enumeration Date | 2011-10-18 |
Last Update Date | 2024-11-05 |