| NPI | 1396257762 |
|---|---|
| Former Name | SHIRLEY ANN OTERO-FURLONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LPN054782) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 693674) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2019-01-24 |