| NPI | 1992103469 |
|---|---|
| Former Name | MAGDALA JEAN JOSEPH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ARNP9283444) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL ARNP9283444) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2017-01-10 |