NPI | 1255912309 |
---|---|
Former Name | JENNA BALSAI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10450588-4405) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363LP2300X Nurse Practitioner, Primary Care (Licence: UT 10450588-4405) | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2024-12-12 |