NPI | 1144779067 |
---|---|
Former Name | MYRTO TELISMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00756000) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP016614) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403472) | |
Enumeration Date | 2016-10-04 |
Last Update Date | 2024-09-09 |