| NPI | 1063862605 |
|---|---|
| Former Name | MARIA ALEXANDROVNA NAZOROVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61090484) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP8761) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2020-10-09 |