| NPI | 1487087664 |
|---|---|
| Former Name | JESSIE ONDINA FUENTES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R205536) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013065) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2023-08-18 |