NPI | 1508491713 |
---|---|
Former Name | PERLA CECILIA CASTRO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016487) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209.016487) |
Enumeration Date | 2020-03-08 |
Last Update Date | 2023-08-17 |