NPI | 1184199747 |
---|---|
Former Name | SUSAN MARIA CULLATY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2283174) |
Enumeration Date | 2018-10-10 |
Last Update Date | 2024-04-29 |