| NPI | 1407670094 |
|---|---|
| Professional Name | JACKIE GONZALEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R131587) |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |