NPI | 1881036135 |
---|---|
Former Name | KELLY MARIE CRONOMIZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024171041) |
Enumeration Date | 2013-07-26 |
Last Update Date | 2016-01-12 |