NPI | 1306170402 |
---|---|
Former Name | BRENDA KOSCHITZKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341692) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 543750) |
Enumeration Date | 2009-09-23 |
Last Update Date | 2019-04-25 |