NPI | 1356757843 |
---|---|
Former Name | DENISE ELIZABETH COSTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11026436) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.16131-NP) |
Enumeration Date | 2014-07-07 |
Last Update Date | 2023-11-07 |