NPI | 1457342982 |
---|---|
Former Name | JACQUELINE BARUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 119372) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 119372) |
363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002624) | |
Enumeration Date | 2005-11-03 |
Last Update Date | 2019-03-13 |