| NPI | 1942985411 |
|---|---|
| Former Name | PETIA J GERVAZOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023023158) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007031329) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2025-07-09 |