NPI | 1255737433 |
---|---|
Former Name | MARY ANNE CASSIANI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012185) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IL 041.287085) |
Enumeration Date | 2014-11-14 |
Last Update Date | 2022-07-21 |