| NPI | 1326706276 |
|---|---|
| Former Name | MAGNOLIA MEDINA MENDOZA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP025005) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2022-05-20 |