NPI | 1508310558 |
---|---|
Former Name | MARLENE ALICE IMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0993043-NP) |
Enumeration Date | 2016-08-08 |
Last Update Date | 2023-05-03 |