NPI | 1902327612 |
---|---|
Former Name | LAURA JEANNE SANTOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 2261893) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2261893) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MA 2261893) | |
Enumeration Date | 2017-07-03 |
Last Update Date | 2021-04-19 |