| NPI | 1720585235 |
|---|---|
| Former Name | AMANDA MARIE CIERVO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007329) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.106646) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |