NPI | 1396427761 |
---|---|
Former Name | SELINA SAMUELLE STA ANA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 873582) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: NY 873582) |
Enumeration Date | 2023-08-03 |
Last Update Date | 2024-09-19 |