NPI | 1780281493 |
---|---|
Former Name | MARIE SYMONE OBA MAGSOMBOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015277) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95015277) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95015277) | |
163W00000X Registered Nurse (Licence: CA 95172209) | |
Enumeration Date | 2020-10-06 |
Last Update Date | 2022-01-11 |