NPI | 1376981357 |
---|---|
Former Name | BETSY J PORTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: KS TMP147024) |
Enumeration Date | 2013-06-12 |
Last Update Date | 2013-06-12 |