NPI | 1952800435 |
---|---|
Former Name | JACLYN ELIZABETH EFRUSY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704299676) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704299676) |
Enumeration Date | 2018-02-09 |
Last Update Date | 2024-01-31 |