| NPI | 1164043162 |
|---|---|
| Former Name | VYACHESLAV OSIPCHUK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: ID 62202) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 62202) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-01-14 |