| NPI | 1558794040 |
|---|---|
| Former Name | VALERIE RENEE NYDAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2261962) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2261962) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2020-10-12 |