| NPI | 1801531793 |
|---|---|
| Former Name | JESSICA ILEANA BLANCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL APRN11019448) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2024-06-04 |