NPI | 1093741449 |
---|---|
Former Name | MARY ORIANS MALVICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201902087NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201902085RN) |
Enumeration Date | 2006-06-25 |
Last Update Date | 2023-05-04 |