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: TX 1070399) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 22374) |
Enumeration Date | 2012-09-24 |
Last Update Date | 2024-09-26 |