NPI | 1942743471 |
---|---|
Former Name | CARISSA PELZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346556) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4919) |
Enumeration Date | 2016-12-01 |
Last Update Date | 2024-09-12 |