| NPI | 1740773118 |
|---|---|
| Former Name | ALISSA ROSE BETANCOURT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 786930) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 786930) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-06-20 |