NPI | 1104496066 |
---|---|
Former Name | MARISIA R PRASKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 8529) |
Additional Taxonomies | 208D00000X General Practice (Licence: MN 8259) |
Enumeration Date | 2021-07-01 |
Last Update Date | 2024-03-19 |