NPI | 1275052805 |
---|---|
Former Name | MARIA ROSE MIRANDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1034526) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00738900) |
Enumeration Date | 2017-09-14 |
Last Update Date | 2021-07-20 |