NPI | 1235441957 |
---|---|
Former Name | MARINA D MAHLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA RN186337) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: VT 026-0067831) |
Enumeration Date | 2010-07-10 |
Last Update Date | 2011-10-07 |