NPI | 1619177557 |
---|---|
Former Name | VIRGINIA SUE DAGGETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041.304192) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28191988A) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2017-01-23 |