NPI | 1851947931 |
---|---|
Former Name | ALLISON MARIE VAILLANCOURT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295137) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2295137) |
Enumeration Date | 2019-08-14 |
Last Update Date | 2020-10-30 |