NPI | 1689314445 |
---|---|
Former Name | MARLEEN DIAN PARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 9034811-4905) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 9034811-4405) |
Enumeration Date | 2022-03-30 |
Last Update Date | 2024-07-25 |