NPI | 1154625788 |
---|---|
Former Name | MICHELLE L KOWALCZYK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1268) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R198424-8) |
Enumeration Date | 2010-12-22 |
Last Update Date | 2020-08-07 |