| NPI | 1255403028 |
|---|---|
| Former Name | JOANNE VERONICA KOSTOWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 200600613522) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2991-33) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-03-10 |