| NPI | 1619302619 |
|---|---|
| Former Name | JENNIE MARIE PIETRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306581) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NY F340918) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2015-11-16 |