NPI | 1689142283 |
---|---|
Former Name | KIMBERLY ANN MARUSIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019532) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA Sp019532) |
363L00000X Nurse Practitioner (Licence: PA SP019532) | |
Enumeration Date | 2018-11-13 |
Last Update Date | 2024-10-09 |