NPI | 1699257956 |
---|---|
Former Name | CRYSTAL ANGELIC ULLAURI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC003892) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001216043) |
363LW0102X Nurse Practitioner, Women's Health (Licence: MD AC003880) | |
Enumeration Date | 2018-09-04 |
Last Update Date | 2022-01-11 |