NPI | 1528799798 |
---|---|
Former Name | EMILY CAROLYN BOREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022021664) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2022013140) |
Enumeration Date | 2022-06-20 |
Last Update Date | 2022-08-05 |