| NPI | 1689959942 |
|---|---|
| Former Name | MARY ROSE PABUSTAN BALUNOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9250094) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9250094) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2013-09-09 |