NPI | 1326303512 |
---|---|
Former Name | MIA M PARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354671) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717745) |
164W00000X Licensed Practical Nurse (Licence: NY 10 290984) | |
Enumeration Date | 2012-07-12 |
Last Update Date | 2024-08-29 |