NPI | 1457789687 |
---|---|
Former Name | ROSA MARIBEL MOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010841) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A105946) |
Enumeration Date | 2013-10-25 |
Last Update Date | 2014-06-27 |