NPI | 1760546022 |
---|---|
Former Name | SANDRA M MORA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209004346) |
Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health (Licence: IN 71001298A) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2007-07-08 |