| NPI | 1639611262 |
|---|---|
| Former Name | MADISON MACARUSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01413) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: RI AT00376) |
| 183700000X Pharmacy Technician (Licence: RI PH106006) | |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2023-01-23 |