NPI | 1124435805 |
---|---|
Former Name | ELIZABETH ANNE MANOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173585) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 16126NP) |
Enumeration Date | 2014-07-15 |
Last Update Date | 2017-02-03 |