NPI | 1376944561 |
---|---|
Former Name | ELIZABETH KROLICZAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00782600) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP014392) |
Enumeration Date | 2014-09-08 |
Last Update Date | 2019-12-03 |