NPI | 1902316938 |
---|---|
Former Name | REBECCA SUSANNE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017033714) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209016632) |
Enumeration Date | 2017-10-04 |
Last Update Date | 2021-03-03 |