| NPI | 1053926949 |
|---|---|
| Former Name | CARLY PICKOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10299-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 10299-33) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2024-01-04 |