NPI | 1790073179 |
---|---|
Former Name | MONICA ELIZABETH SLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH 14496) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R193147) |
363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3011158) | |
Enumeration Date | 2011-07-19 |
Last Update Date | 2020-07-01 |