NPI | 1427567049 |
---|---|
Former Name | JACQUELYNN CAMACLANG BANABAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95007291) |
Enumeration Date | 2017-09-26 |
Last Update Date | 2025-07-28 |