| NPI | 1093419731 |
|---|---|
| Former Name | MAYRA YOLANDA MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2025-06-05 |