NPI | 1447663976 |
---|---|
Former Name | MEGAN MARIE CZYZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R182536) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R182536) |
363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000851) | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2020-10-06 |