NPI | 1730514472 |
---|---|
Former Name | LORIE MARIE RESKIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76158) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2013033427) |
Enumeration Date | 2013-09-12 |
Last Update Date | 2015-02-10 |