NPI | 1811644735 |
---|---|
Former Name | BETZY MIRANDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11017124) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11017124) |
Enumeration Date | 2022-03-10 |
Last Update Date | 2025-04-30 |