| NPI | 1932482809 |
|---|---|
| Former Name | MIRANDA Y VEGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75441) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75441-121) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: KS 53-75441) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2020-06-10 |