NPI | 1528043767 |
---|---|
Former Name | LAURA MARIE AGOSTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2001019009) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 019009) |
Enumeration Date | 2005-12-09 |
Last Update Date | 2021-01-18 |