| NPI | 1205615556 |
|---|---|
| Former Name | AMBER DAWN MAZZOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028809) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11028809) |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2025-01-21 |