NPI | 1326694175 |
---|---|
Former Name | CAROLE LEIGH CZEPIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020520) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP020520) |
Enumeration Date | 2019-08-16 |
Last Update Date | 2022-09-19 |