NPI | 1265199244 |
---|---|
Former Name | DIANE GISELLE ANANOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA RN2310852) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2310852) |
Enumeration Date | 2021-11-24 |
Last Update Date | 2022-01-06 |