| NPI | 1265617310 |
|---|---|
| Former Name | MARIE ELENA CORDISCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 46044) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT CT 004452) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2012-05-22 |