NPI | 1740046044 |
---|---|
Former Name | JACQUELYN REYNALDO CRUZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R171575) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R171575) |
Enumeration Date | 2024-02-23 |
Last Update Date | 2024-08-16 |