NPI | 1457003139 |
---|---|
Former Name | DESERIEE PADILLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WY 49265) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 49265) |
Enumeration Date | 2022-01-24 |
Last Update Date | 2024-09-12 |