NPI | 1962170886 |
---|---|
Former Name | MELISSA MARIE ZIDAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5015009) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC NOLA-D6VV9) |
Enumeration Date | 2021-09-03 |
Last Update Date | 2021-10-26 |