NPI | 1376736082 |
---|---|
Former Name | CHARLENE MARIE TUNKIEICZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9227595) |
Enumeration Date | 2007-08-27 |
Last Update Date | 2011-10-07 |