NPI | 1801172598 |
---|---|
Former Name | MELISSA OVALLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202103250NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 766077) |
Enumeration Date | 2011-10-26 |
Last Update Date | 2021-07-09 |