| NPI | 1326752924 |
|---|---|
| Former Legal Business Name | MAGNOLIA AESTHETICS, INC |
| Entity Type | Organization |
| Authorized Contact | DARYA P ZAKIROV President 508-837-5623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2024-09-19 |