| NPI | 1235199605 |
|---|---|
| Former Name | EILEEN MIKIELIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 119994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN119994) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2014-02-26 |