| NPI | 1184267221 |
|---|---|
| Former Name | KATIE FIDAZZO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP143547) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP143547) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2024-01-24 |