NPI | 1578688560 |
---|---|
Former Name | LYDIA WOOD CORNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704215985) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MI 4704215985) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2007-08-28 |