| 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 |