NPI | 1265077424 |
---|---|
Former Name | VANESSA M GODOY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-020127) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-020127) |
Enumeration Date | 2019-11-12 |
Last Update Date | 2025-01-22 |