| NPI | 1174012223 |
|---|---|
| Former Name | JACQUELINE JANE CORDOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: WA AP60824126) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2020-11-25 |