NPI | 1467737189 |
---|---|
Former Name | ELIZABETH ELLEN CERRENTANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0992400) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008690) |
Enumeration Date | 2011-10-13 |
Last Update Date | 2020-09-15 |