NPI | 1881884229 |
---|---|
Other Name | DEREK VILLAREAL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 22 580183) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 431496) |
Enumeration Date | 2007-08-01 |
Last Update Date | 2019-09-18 |