| NPI | 1083954481 |
|---|---|
| Former Name | NICOLE RUSZCZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB11999600) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT015293) |
| 208600000X Surgery (Licence: OH 34013891) | |
| 208600000X Surgery (Licence: PA OS018230) | |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2024-02-29 |