NPI | 1639501877 |
---|---|
Former Name | CAROLYN MARIE PERROTTI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003836) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.005412) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95003836) | |
Enumeration Date | 2013-07-30 |
Last Update Date | 2021-08-16 |