| NPI | 1063190072 |
|---|---|
| Former Name | NATALIE CAROL DIVERSIEV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 296951) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 2023062535) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-10-17 |