NPI | 1396254058 |
---|---|
Former Name | ALISON KUSYJ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95007188) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CA 95007188) |
363LF0000X Nurse Practitioner Family (Licence: CA 95007188) | |
Enumeration Date | 2017-09-26 |
Last Update Date | 2019-04-09 |