NPI | 1366886301 |
---|---|
Former Name | SUSAN DEVITO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005321) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 5321) |
Enumeration Date | 2013-04-22 |
Last Update Date | 2022-09-11 |