| NPI | 1942843644 |
|---|---|
| Former Name | STEPHANIE MENDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009684A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28235757A) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2021-11-11 |