NPI | 1164003182 |
---|---|
Former Name | RAQUEL ALEXANDRA CEBALLOS MENDOZA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 0028706) |
Enumeration Date | 2021-04-20 |
Last Update Date | 2024-10-10 |