NPI | 1659887453 |
---|---|
Former Name | DESTINY NICOLE LAGARCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23611) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012044) |
Enumeration Date | 2017-12-17 |
Last Update Date | 2024-04-24 |