NPI | 1093765786 |
---|---|
Former Name | MARYLOU RITACCO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003031) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003031) |
363L00000X Nurse Practitioner (Licence: RI NP36913) | |
Enumeration Date | 2006-05-11 |
Last Update Date | 2015-04-14 |