| NPI | 1568982239 |
|---|---|
| Former Name | LAURA ELLEN DISTEFANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2260431) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |