| NPI | 1831811124 |
|---|---|
| Former Name | ALYSHAA MARIE AGBULOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350369) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95026066) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209025907) | |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2025-09-05 |