| NPI | 1609146471 |
|---|---|
| Former Name | MYRA ANNE DIAZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A149392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A149392) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2025-05-01 |