NPI | 1346765344 |
---|---|
Former Name | THERESA L MUNOZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704337222) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209015830) |
Enumeration Date | 2017-08-10 |
Last Update Date | 2023-08-17 |