NPI | 1134760465 |
---|---|
Former Name | GABRIELLE MARIE LATORRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021040) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN687150) |
Enumeration Date | 2019-10-08 |
Last Update Date | 2021-07-23 |