| NPI | 1669244489 |
|---|---|
| Former Name | CARLY ADAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028716) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.486742) |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2024-04-30 |