NPI | 1467890657 |
---|---|
Former Name | CODY E BASCIANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010451) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013012822) |
Enumeration Date | 2013-06-10 |
Last Update Date | 2023-05-09 |