NPI | 1730499492 |
---|---|
Former Name | KELLY J KOPERSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3375) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R131031-7) |
Enumeration Date | 2010-10-15 |
Last Update Date | 2020-08-07 |