NPI | 1770730392 |
---|---|
Former Name | CORALYN BALCUNS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 78102) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP116963) |
363LF0000X Nurse Practitioner, Family (Licence: ID 78102) | |
363LF0000X Nurse Practitioner, Family (Licence: TX AP116963) | |
Enumeration Date | 2008-08-26 |
Last Update Date | 2024-06-25 |