NPI | 1518215490 |
---|---|
Former Name | MARIELLE ZYLSTRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN265510) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI APRN00771) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2023-11-14 |