| NPI | 1619221587 |
|---|---|
| Former Name | ANDREA DEE SANTOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 151614) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN151614) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2018-05-14 |