NPI | 1518480052 |
---|---|
Former Name | BREA A KACZOROWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 7767-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 200530-30) |
Enumeration Date | 2017-07-17 |
Last Update Date | 2019-11-14 |