NPI | 1518687417 |
---|---|
Former Name | MARIANA LOUISE GOLPHIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 311920) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP026201) |
Enumeration Date | 2022-08-31 |
Last Update Date | 2025-04-23 |