NPI | 1063135101 |
---|---|
Former Name | MACKENZIE KAYLA SNAZA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F351836) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 9633) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-09-23 |
Last Update Date | 2024-09-19 |