| NPI | 1043635162 |
|---|---|
| Former Name | ALODIA BANUELOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5625) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN135342) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2021-04-23 |