| NPI | 1184603342 |
|---|---|
| Former Name | MARY ELLEN MERVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AZ RN043733) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ RN043733) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ AP0078) | |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2017-03-10 |