| NPI | 1902630254 |
|---|---|
| Former Name | ELLISA ANNE RUCINSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71015564A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28241444A) |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-09-30 |