NPI | 1871593970 |
---|---|
Former Name | TERESA LARIOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 530702) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 15162) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2007-07-08 |