NPI | 1104472406 |
---|---|
Former Name | JAIMA L BAGIENSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28154489A) |
Enumeration Date | 2019-08-13 |
Last Update Date | 2024-04-02 |