NPI | 1104336833 |
---|---|
Former Name | LARA CAMILLE CRUZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95007024) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 796719) |
Enumeration Date | 2017-10-09 |
Last Update Date | 2021-08-18 |