| NPI | 1881092377 |
|---|---|
| Former Name | JULIANNA PROVOST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MD R213836) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2023-05-19 |