| NPI | 1487168514 |
|---|---|
| Former Name | LUDWIKA ZENOBIA BLACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN210975) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-151191) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2018-12-06 |