| NPI | 1164823308 |
|---|---|
| Former Name | ELAINE JOAN MANCUSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013968) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP013968) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP013968) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2020-02-04 |