NPI | 1568603975 |
---|---|
Former Name | KARINA ISELA REYNOSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CA 743106) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95016201) |
Enumeration Date | 2009-03-13 |
Last Update Date | 2021-03-09 |