| NPI | 1528785037 |
|---|---|
| Former Name | VIRGINIA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1086639) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1086639) |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2023-01-16 |