NPI | 1609127133 |
---|---|
Former Name | MARY ANN JANICE MALLORCA LAUDICO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002265) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1070399) |
363LF0000X Nurse Practitioner, Family (Licence: CA 22374) | |
Enumeration Date | 2012-09-24 |
Last Update Date | 2025-09-12 |