| NPI | 1851173603 |
|---|---|
| Former Name | ANISA ACEVEDO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704326536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4704326536) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2024-04-26 |