NPI | 1508273590 |
---|---|
Former Name | MALLORY LOUISE MARKIEWICZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-198535) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60485703) |
Enumeration Date | 2014-07-22 |
Last Update Date | 2024-02-19 |