| NPI | 1528336021 |
|---|---|
| Former Name | MARISSA LEE NEROUTSOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 402689) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 646146) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2023-08-01 |