| NPI | 1265202287 | 
|---|---|
| Former Name | WENDY DE LOS SANTOS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: AZ 298060) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 298060) | 
| Enumeration Date | 2024-01-02 | 
| Last Update Date | 2024-09-09 |