| 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 |