NPI | 1528428273 |
---|---|
Former Name | DEBORAH SUE MACUICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010448) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.18846-NP) |
Enumeration Date | 2016-02-23 |
Last Update Date | 2020-09-16 |