NPI | 1316665896 |
---|---|
Former Name | ALEXA BEVERLY TROCINSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11021530) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 39) |
Enumeration Date | 2022-08-19 |
Last Update Date | 2022-10-06 |