NPI | 1972104479 |
---|---|
Former Name | ELIZABETH ROSE FERGUSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-146153) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: AL 1-146153) |
Enumeration Date | 2020-11-03 |
Last Update Date | 2020-11-03 |