NPI | 1982003158 |
---|---|
Former Name | BIANCA MEDINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 73290) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-72297) |
Enumeration Date | 2014-08-14 |
Last Update Date | 2023-04-25 |