| NPI | 1518340611 |
|---|---|
| Former Name | CLERISSA AGONCILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11031981) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339432-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00591000) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11031981) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-06-27 |