NPI | 1497225767 |
---|---|
Former Name | ALYSSA MARIE INDELICATO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011233) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011233) |
Enumeration Date | 2018-11-29 |
Last Update Date | 2020-05-15 |