NPI | 1700247822 |
---|---|
Former Name | MARY PATRICIA DESIMONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20841) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 301003) |
363LF0000X Nurse Practitioner, Family (Licence: KY 301003) | |
Enumeration Date | 2016-03-16 |
Last Update Date | 2024-08-22 |