Individual
KWAGHDOO ATSOR BOSSUAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209032307
IL
363LF0000X
Family Nurse Practitioner
4704211774
MI
Other
Enumeration date
01/14/2009
Last updated
11/04/2025
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