NPI | 1932740297 |
---|---|
Former Name | JOSEFINA VICCAMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11022971) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9305687) |
Enumeration Date | 2019-10-07 |
Last Update Date | 2023-01-20 |