NPI | 1558611772 |
---|---|
Former Name | SARAH ANN MATTAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5016870) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 5147) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005147) | |
Enumeration Date | 2012-09-14 |
Last Update Date | 2022-09-13 |