| NPI | 1063065944 |
|---|---|
| Former Name | LAURA RUSNACKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201905604NP-PP) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2022-08-29 |