| NPI | 1720474687 |
|---|---|
| Former Name | CASANDRA ELAINE RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012471) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015009441) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-07-08 |