| 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 |