| NPI | 1003530668 |
|---|---|
| Former Name | REBECCA FAITH SANDSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-APRN-LIC-198093) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |