NPI | 1689200180 |
---|---|
Former Name | ANGELICA PERALTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11007646) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL F01201812) |
Enumeration Date | 2020-03-16 |
Last Update Date | 2021-03-24 |