NPI | 1851768022 |
---|---|
Former Name | ILSA MCEWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 19047) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 202409) |
363LP2300X Nurse Practitioner, Primary Care (Licence: WI 6600-33) | |
Enumeration Date | 2015-08-24 |
Last Update Date | 2024-10-10 |