NPI | 1619603719 |
---|---|
Former Name | JENNIFER BELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021128) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010001) |
Enumeration Date | 2022-07-29 |
Last Update Date | 2022-07-29 |