NPI | 1386486512 |
---|---|
Former Name | CASSANDRA DEPAUW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354998) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 753057) |
Enumeration Date | 2024-06-10 |
Last Update Date | 2024-08-23 |