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Individual
LATIA IRENE O'BANNER
Active
Individual
LATIA IRENE O'BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R162086
MD
163W00000X
Registered Nurse
RN626135
PA
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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