| NPI | 1194282111 |
|---|---|
| Former Name | TINA SANDOVAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95038072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0994558-NP) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2026-05-11 |