NPI | 1841603917 |
---|---|
Former Name | ELISE BOWMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010248) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP013050) |
Enumeration Date | 2014-06-06 |
Last Update Date | 2017-03-16 |