NPI | 1386196210 |
---|---|
Former Name | ROSE M JUSZCZAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 7363-33) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 7363-33) |
363LP2300X Nurse Practitioner, Primary Care (Licence: WI 7363-33) | |
Enumeration Date | 2016-10-26 |
Last Update Date | 2023-02-06 |