NPI | 1114478112 |
---|---|
Former Name | AMY ZIEZULEWICZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113011) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 57576) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2022-01-18 |