NPI | 1184137168 |
---|---|
Former Name | JALEESA RANAE ANDRADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: PA SP018122) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018122) |
Enumeration Date | 2017-11-13 |
Last Update Date | 2022-04-22 |