NPI | 1497486518 |
---|---|
Former Name | ELENA SHALON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 280124) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 293053) |
363LF0000X Nurse Practitioner, Family (Licence: NC F06220676) | |
363LF0000X Nurse Practitioner, Family (Licence: AZ 280124) | |
Enumeration Date | 2022-06-20 |
Last Update Date | 2024-05-07 |