NPI | 1720572878 |
---|---|
Former Name | GALAXIE REDMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277003010) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209017779) |
363L00000X Nurse Practitioner (Licence: IL 209017779) | |
Enumeration Date | 2018-06-20 |
Last Update Date | 2024-10-28 |