| NPI | 1861768970 |
|---|---|
| Former Name | CYNTHIA WAGNER AVELLINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP011729) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011729) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2022-07-21 |