NPI | 1912730052 |
---|---|
Former Name | ALEXA RENEE DEMANUEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 353283) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 809745) |
Enumeration Date | 2024-08-23 |
Last Update Date | 2024-08-23 |