| NPI | 1952810772 |
|---|---|
| Former Name | DIVINA GRACIA R. DELA PENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA NP7363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA NP7363) |
| 363LS0200X Nurse Practitioner School (Licence: CA NP7363) | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-10-02 |