| NPI | 1467826974 |
|---|---|
| Former Name | GENEVIEVE OSMUNDO CUSTODIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019500) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2022-04-07 |