NPI | 1609226778 |
---|---|
Former Name | DENA D BANTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992451-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.0160888) |
Enumeration Date | 2016-06-20 |
Last Update Date | 2022-07-11 |