| NPI | 1679099956 |
|---|---|
| Former Name | DIANE ELIZABETH MIPRO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09582) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131607) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2021-08-13 |