NPI | 1659034395 |
---|---|
Former Name | MELISSA FERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012692) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11012692) |
Enumeration Date | 2021-10-19 |
Last Update Date | 2024-06-26 |