| NPI | 1942230628 |
|---|---|
| Former Name | VICTORIA SERGEYEVNA IVCHENKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R1579718) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |