| NPI | 1306223813 |
|---|---|
| Professional Name | YAROSLAV ANATOLEVICH FISUN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP014633) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP014633) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-12-09 |