| NPI | 1619131455 |
|---|---|
| Former Name | PATRICIA COSTALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP01127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM R46544) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-02-02 |