NPI | 1295568004 |
---|---|
Former Name | AMELIA KLONECKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 15483) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 2250703) |
Enumeration Date | 2024-08-26 |
Last Update Date | 2025-04-28 |