NPI | 1720453566 |
---|---|
Former Name | JILLIAN TRABERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14534) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 199731) |
Enumeration Date | 2015-12-04 |
Last Update Date | 2024-05-30 |