NPI | 1275044703 |
---|---|
Former Name | SNOOKY GENALIN DAGALA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95007818) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 749726) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95007818) | |
Enumeration Date | 2017-10-24 |
Last Update Date | 2022-07-09 |