NPI | 1437624087 |
---|---|
Former Name | AMANDA GRASSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN02705) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015976) |
363LF0000X Nurse Practitioner, Family (Licence: CT 7804) | |
Enumeration Date | 2018-10-10 |
Last Update Date | 2021-11-12 |