NPI | 1528393097 |
---|---|
Former Name | MARY L KNOX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007815) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.007815) |
Enumeration Date | 2009-10-16 |
Last Update Date | 2024-01-29 |