NPI | 1013013762 |
---|---|
Former Name | CORIN ALYSIA SHENUSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006017) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 003449) |
Enumeration Date | 2006-09-16 |
Last Update Date | 2016-09-21 |