NPI | 1982012449 |
---|---|
Former Name | JANICE LOPEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9453730) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382451-1) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9453730) | |
Enumeration Date | 2014-07-29 |
Last Update Date | 2017-11-21 |