NPI | 1528302742 |
---|---|
Former Name | GINA MARIE VITALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH RN278267) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO RN115701) |
363L00000X Nurse Practitioner (Licence: OH COA-NP14020) | |
Enumeration Date | 2012-11-15 |
Last Update Date | 2015-10-20 |