NPI | 1790352433 |
---|---|
Former Name | MOLLY ELIZABETH LYON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 9719) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 9719) |
Enumeration Date | 2021-06-10 |
Last Update Date | 2021-07-02 |