| NPI | 1114258456 |
|---|---|
| Former Name | JOHANNA CUNICO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-103344) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-103344) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2021-08-10 |