NPI | 1407197072 |
---|---|
Other Name | CAROLYN WATERBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005298) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337508-1) |
Enumeration Date | 2013-03-07 |
Last Update Date | 2017-03-24 |