| NPI | 1114760121 |
|---|---|
| Former Name | CARLY ANNE SANSOUCY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11040847) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: FL 9530122) |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2026-02-26 |