| NPI | 1194378554 |
|---|---|
| Former Name | CHRISTINE MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11019461) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F344748-01) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2023-01-19 |