| NPI | 1639929474 |
|---|---|
| Former Name | JEZZELL PRIME SALONTOY BADANGUIO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95028727) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2025-10-30 |