NPI | 1063821064 |
---|---|
Former Name | RACHELLE CARELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019159) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 79102) |
Enumeration Date | 2014-08-05 |
Last Update Date | 2024-03-26 |