NPI | 1700556347 |
---|---|
Former Name | MERRY GRACE EMILIO CONSERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95016756) |
Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 4921) |
Enumeration Date | 2021-09-15 |
Last Update Date | 2022-05-03 |