| NPI | 1669081519 |
|---|---|
| Former Name | SAN JUANITA VARGAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81235-122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 101659) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2024-01-20 |