NPI | 1821316837 |
---|---|
Former Name | MARY J DORENCZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704224949) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209008161) |
Enumeration Date | 2010-05-14 |
Last Update Date | 2023-08-30 |