NPI | 1821412701 |
---|---|
Former Name | RACHEL A DZIALO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015031260) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77172) |
363L00000X Nurse Practitioner (Licence: TN 180465) | |
Enumeration Date | 2014-02-12 |
Last Update Date | 2018-06-05 |