NPI | 1730686015 |
---|---|
Former Name | KAYLA SASSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017497) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041412855) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2019-05-07 |