NPI | 1437780376 |
---|---|
Former Name | JENNIFER JANE IACUZZI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 053599-23) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-01-29 |
Last Update Date | 2021-04-28 |