| NPI | 1639585045 |
|---|---|
| Former Name | PRISCILA MORENO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 97357) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704320224) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 000000) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-11-30 |