| NPI | 1538348016 |
|---|---|
| Former Name | CORTNEY LYNN THALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MO 2002016209) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2020-11-13 |