NPI | 1245619295 |
---|---|
Former Name | NORA DERVARTANIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002976) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 576354) |
363L00000X Nurse Practitioner (Licence: CA 95002976) | |
Enumeration Date | 2015-05-22 |
Last Update Date | 2016-03-08 |