| NPI | 1770067167 |
|---|---|
| Former Name | JACQUELINE S MONTOYA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 54056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 54056) |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2024-05-17 |