NPI | 1326880626 |
---|---|
Former Name | ALLISON SHEA MAZZOTTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 080011-21) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2306105) |
Enumeration Date | 2024-06-10 |
Last Update Date | 2024-07-12 |