NPI | 1316411481 |
---|---|
Former Name | CASSANDRA DESJARDINS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2312573) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2312573) |
Enumeration Date | 2019-01-11 |
Last Update Date | 2022-06-02 |