| NPI | 1598708125 |
|---|---|
| Former Name | JACQUELINE PULANCO FERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MDR-7684) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200450060NP) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-06 |