NPI | 1790932721 |
---|---|
Former Name | ELAINE GAYLE LUKASAVITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: MI 4704091276) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704091276) |
207V00000X Obstetrics & Gynecology (Licence: MI 4704091276) | |
Enumeration Date | 2008-08-21 |
Last Update Date | 2011-11-22 |