| NPI | 1972202703 |
|---|---|
| Former Name | ASHLEY LAUREN FANJOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26498) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 26498) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-03-17 |