| NPI | 1790994697 |
|---|---|
| Former Name | CHERYL L MALO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950082NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 14753) |
| 363L00000X Nurse Practitioner (Licence: NV 00494) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-08-14 |