| NPI | 1336828912 |
|---|---|
| Former Name | SYDNEY FANTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 221073) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 221073) |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2024-05-07 |