NPI | 1417959032 |
---|---|
Former Name | DALE MARIE VENTIMIGLIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA T061905) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2014-08-05 |