| NPI | 1497167886 |
|---|---|
| Former Name | SARA MARIE PETRUCCI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9336292) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9336292) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2015-05-04 |