| NPI | 1245821131 | 
|---|---|
| Other Name | MAZEN EL KOUDSI | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704343520) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704343520) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704343520) | |
| Enumeration Date | 2021-02-02 | 
| Last Update Date | 2021-05-11 |