NPI | 1972247401 |
---|---|
Former Name | SHAUNA M BARRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041485032) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.025741) |
Enumeration Date | 2022-04-21 |
Last Update Date | 2022-10-14 |